title: Nonobstructive hypertrophic cardiomyopathy with left ventricular aneurysm: the role of cardiac magnetic resonance.
abstract: Hypertrophic cardiomyopathy with concomitant left ventricular aneurysm is rare and has important clinical implications, including an increased risk of sudden cardiac death. Most patients with this rare combination have obstructive hypertrophic cardiomyopathy, but we treated a 26-year-old woman who had nonobstructive hypertrophic cardiomyopathy and a family history of probable sudden cardiac death. In our patient, coronary angiograms showed distal occlusion of the left anterior descending coronary artery. Late gadolinium-enhanced cardiac magnetic resonance images showed scattered fibrosis within and beyond the left ventricular aneurysm. Precautionary therapy with an implantable cardioverter-defibrillator yielded an uneventful outcome. Cardiac magnetic resonance has emerged as a promising method for diagnosing these aneurysms and detecting associated myocardial fibrosis, thereby enabling patient risk stratification and the determination of appropriate therapeutic options. We discuss the role of cardiac magnetic resonance imaging in the management of this rare clinical entity.
authors.affiliation: Departments of Internal Medicine (Drs. Luni and Moza), Cardiovascular Medicine (Drs. Chaganti, Kanjwal, and Sheikh), and Radiology (Drs. Coker and Lewis), University of Toledo Medical Center, Toledo, Ohio 43614.
authors.forename: Faraz Khan
authors.initials: FK
authors.lastname: Luni
authors.forename: Ankush
authors.initials: A
authors.lastname: Moza
authors.forename: Mujeeb
authors.initials: M
authors.lastname: Sheikh
authors.forename: Melinda F
authors.initials: MF
authors.lastname: Coker
authors.forename: Srivasvi K
authors.initials: SK
authors.lastname: Chaganti
authors.forename: Terrence J
authors.initials: TJ
authors.lastname: Lewis
authors.forename: Yousuf
authors.initials: Y
authors.lastname: Kanjwal
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D017023:Coronary Angiography; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000295:instrumentation; D005260:Female; D005355:Fibrosis; D006322:Heart Aneurysm / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D011237:Predictive Value of Tests
keywords: Cardiomyopathy, hypertrophic, familial/complications/pathology/therapy; coronary aneurysm/complications/diagnosis/therapy; death, sudden, cardiac/etiology; defibrillators, implantable; gadolinium/diagnostic use; image enhancement/instrumentation/methods; magnetic resonance imaging; risk assessment